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Intracranial brain parenchymal spread of mucormycosis through olfactory tract: a diffusion-weighted imaging-based
J Sandron1, Ph Hantson1, T Duprez1
1Department of Neuroradiology, Clinique Universitaire St-Luc, Bruxelles, Belgium.
Abstract:
Mucormycosis is an opportunistic fungal infection involving among others the paranasal sinuses, nasal fossa and brain parenchyma. Mucor can invade the brain parenchyma by either contiguous spread from the paranasal sinuses or through vascular invasion. We report a case of fatal rhino-cerebral mucormycosis in whom cytotoxic edema at magnetic resonance diffusion-weighted imaging was symmetrically restricted to both neocortical and paleocortical primary areas of olfactory projection at earliest phase of the disease process. Shortly later tissue damage extended into the whole brain. This undescribed observation raised the hypothesis of preferential way of brain invasion by Mucor through the olfactory tract.
Insights
Mucormycosis, a fungal infection, can invade the brain. This case suggests Mucor may preferentially spread through the olfactory tract, causing early brain edema in specific areas.
Area of Science:
- Neurology
- Infectious Diseases
- Mycology
Background:
- Mucormycosis is a severe opportunistic fungal infection.
- Rhino-cerebral mucormycosis affects sinuses, nasal cavity, and brain.
- Brain invasion occurs via contiguous spread or vascular invasion.
Observation:
- A fatal case of rhino-cerebral mucormycosis was analyzed.
- Early magnetic resonance diffusion-weighted imaging showed cytotoxic edema.
- Edema was symmetrically restricted to primary olfactory projection areas.
Findings:
- This pattern of early edema suggests a preferential route of brain invasion.
- The olfactory tract may be a primary pathway for Mucor to reach the brain.
- Subsequent rapid, widespread brain tissue damage was observed.
Implications:
- This finding challenges the traditional understanding of Mucor brain invasion routes.
- It highlights the olfactory tract as a potential early target in rhino-cerebral mucormycosis.
- Further research is needed to confirm this preferential invasion pathway.
